实证肠炎方联合美沙拉嗪治疗中重度大肠湿热型溃疡性结肠炎临床观察

[目的]观察实证肠炎方结合美沙拉嗪治疗中重度大肠湿热型溃疡性结肠炎(ulcerative colitis,UC)的临床疗效。[方法]将符合纳入标准的患者72例随机分为中西组和西药组各36例,西药组予美沙拉嗪口服,中西组在西药组的基础上加服实证肠炎方,两组均治疗4周。治疗后,通过观察症状积分、中医证候疗效、改良Mayo评分、生活质量评分、血液理化指标、不良反应进行临床疗效评价。[结果]治疗后中西组患者总有效率为91.67%,西药组患者总有效率为80.56%,差异有统计学意义(P<0.01)。治疗后两组患者症状积分均比治疗前低,差异有统计学意义(P<0.01)。治疗后,中西组腹泻、脓血便、腹痛、里急后重的症状积分及改良Mayo评分、C反应蛋白(Creactive protein,CRP)水平较西药组低,炎症性肠病生活质量问卷(inflammatory bowel disease questionnaire,IBDQ)评分较西药组高,差异均有统计学意义(P<0.05)。治疗过程中中西组未见不良反应,西药组出现胃部不适症状3例。[结论]实证肠炎方联合美沙拉嗪口服治疗中重度大肠湿热型UC具有良好的临床疗效,能有效缓解临床症状,抑制炎症反应,提升生活质量,而且安全性高。

Clinical Observation of Shizheng Changyan Formula Combined with Mesalazine in Treatment of Moderate to Severe Ulcerative Colitis Large Intestine Damp-heat Syndrome

[Objective]To observe the clinical efficacy of Shizheng Changyan Formula combined with Mesalazine in treatment of moderate to severe large intestine damp-heat syndrome ulcerative colitis(UC). [Methods]Totally 72 cases who met the inclusion criteria were randomly divided into integrated traditional Chinese and western medicine group, and western medicine group, each group had 36 cases. Patients in western medicine group were given Mesalazine orally, and patients in integrated traditional Chinese and western medicine group were given Shizheng Changyan Formula on the basis of western medicine group. Both groups were treated for 4 weeks. After treatment, the clinical efficacy was evaluated by symptom scores, the efficacy of traditional Chinese medicine(TCM) syndromes, the modified Mayo scores, inflammatory bowel disease questionnaire(IBDQ) scores, blood physical and chemical indicators, and adverse reactions. [Results] After 4 weeks of treatment, the total effective rate of patients in integrated traditional Chinese and western medicine group was 91.67 %, and the total effective rate of patients in western medicine group was 80.56%, the difference was statistically significant(P <0.01). After treatment, the symptom scores of the two groups were lower than before treatment, and the difference was statistically significant(P<0.01). After treatment, symptom scores of diarrhea, bloody mucopurulent stool, abdominal pain, tenesmus diarrhea, the modified Mayo score,and the level of C reactive protein(CRP) in integrated traditional Chinese and western medicine group were lower than those in western medicine group, and the IBDQ scores were higher than that in western medicine group, and the difference was statistically significant(P<0.05). During the treatment, there were no adverse reactions in integrated traditional Chinese and western medicine group, and 3 cases of stomach discomfort appeared in the western medicine group. [Conclusion]Shizheng Changyan Formula combined with Mesalazine has clinical curative effect in treatment of moderate to severe large intestine damp-heat syndrome UC, which can effectively relieve clinical symptoms, restrain inflammation, improve quality of life, and it has high security.